MRI Versus Helical CT for Endoleak Detection After Endovascular Aneurysm Repair

Abstract

MRI is significantly superior to biphasic CT for endoleak detection and rating of endoleak size, followed by uniphasic late and uniphasic arterial CT scans. MRI shows a significant number of endoleaks in cases with negative CT findings and may help illuminate the phenomenon of endotension. Endoleak rates reported after endovascular aneurysm repair substantially depend on the imaging techniques used.

Duplex ultrasound in aneurysm surveillance following endovascular aneurysm repair: a comparison with computed tomography aortography

“…Pitton et al report sensitivity for endoleak detection of 92.9% for magnetic resonance imaging (MRI) versus 44% for biphasic CT in their follow-up study of 52 patients. 15 Van der Lean et al found that MRI detected endoleaks in 23 of 35 of the patients who they studied, compared with only 11 of the same group in whom endoleaks were detected by CTA. 16 Both authors conclude that MRI is significantly more sensitive than CTA for the detection of endoleaks.…”

Clinical Practice Guidelines for Endovascular Abdominal Aortic Aneurysm Repair: Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association

“…In several studies involving small numbers of patients with predominantly nitinol stents, MR angiography was at least as sensitive as CT angiography (131)(132)(133)(134)(135), and in some cases demonstrated endoleaks that were not detected on CT angiography. In one case report (136), endotension was suspected in two patients with enlarging aneurysm sacs and no endoleak on CT angiography, but a subsequent MR angiogram demonstrated type II endoleaks.…”

Safety of Magnetic Resonance Imaging in Patients With Cardiovascular Devices

“…43 Thus far, there have been several published studies of MR examinations in patients with aortic stent grafts that have not noted any adverse clinical events related to the MR examinations. 44,45 The MR characteristics of the Zenith AAA endovascular graft (Cook) have been evaluated through bench testing in MR systems with static fields of Յ1.5 T, and this stent graft was found to exhibit significant deflection and torque of the stainless steel metallic component of the endovascular graft and therefore did not meet standard "MR safe" bench test criteria. 46 A practical consideration in MR examinations of endovascular stents relates to the potential magnetic susceptibility effects (artifacts) induced by the metallic components of the stent grafts.…”